Pericardial effusion following cardiac surgery. A single-center experience

Abstract

Background Pericardial effusion is still a common postoperative complication after open heart surgery with cardiopulmonary bypass. Pericardial effusion significantly prolongs the hospital stay and associated costs as well as affecting overall outcomes after open heart surgery in Hanoi Heart Hospital, a tertiary hospital in Vietnam with an annual volume of 1000 patients. This study aimed to investigate the clinical presentation, incidence, and risk factors of postoperative pericardial effusion, which may ensure better prevention of pericardial effusion and improvement in surgical outcomes after open heart surgery. Methods A cross-sectional study was performed on 1127 patients undergoing open heart surgery from January 2015 to December 2015. Results Thirty-six (3.19%) patients developed pericardial effusion. Of these, 16 (44.4%) had cardiac tamponade. Pericardial effusion occurred after valve procedures in 77.8% of cases. Pericardial effusion was detected after discharge in 47.2% of cases at a mean time of 18.1 ± 13.7 days. Univariate logistic regression analysis showed that age> 25 years, body surface area ≥ 1.28 m, preoperative liver dysfunction, New York Heart Association class III/IV, left ventricular end-diastolic diameter z score ≥ 0.55, and postoperative anticoagulant use were associated with postoperative pericardial effusion. Multivariate logistic regression analysis showed that left ventricular end-diastolic diameter z score ≥ 0.55 was an independent risk factor for postoperative pericardial effusion. Conclusions Routine postoperative echocardiography is necessary to detect postoperative pericardial effusion. Increased left ventricular end-diastolic dimension is an independent predictor of postoperative pericardial effusion.

Causes and characteristics associated with early and late readmission after open‐heart valve surgery

“…Patients that were younger, male, had increased alcohol consumption and underwent mitral valve surgery compared with aortic valve surgery had an increased risk of readmission due to effusions. Previous studies have suggested arrhythmias, larger body surface area, anti‐coagulation treatment, and cardiac enlargement are associated with pericardial effusion 18–20 . Earlier studies have focused on factors associated with the development of effusions in general, including in the early postoperative period during the index admission, rather than factors associated with readmissions 18,20 .…”

“…Permanent pacemaker, n (%) 6 (2) [18][19][20] Earlier studies have focused on factors associated with the development of effusions in general, including in the early postoperative period during the index admission, rather than factors associated with readmissions. 18,20 Furthermore, predicting readmissions due to pericardial effusions might also be difficult, as the risk of atrial fibrillation increases as a Mechanical aortic valve 52 (21) 100 (14) .010* 15 (13) 85 (14) .768…”

Atrial fibrillation as a contributing factor in the diagnostic algorithm for coronary subclavian steal syndrome and cardiac tamponade following coronary artery bypass graft surgery: a case study

“…Echocardiography is a well-utilized diagnostic tool in the assessment of pericardial effusion (9). Nevertheless, postoperative echocardiography is not always performed before hospital discharge after cardiac surgery.…”

Resuscitative transesophageal echocardiography in the diagnosis of post-CABG loculated pericardial clot causing cardiac tamponade

“…Pericardial effusion is a known complication of open cardiac surgery with 1-3% of patients needing intervention [1][2][3]. Postoperative pericardial effusion secondary to bleeding into the pericardial sac is commonly identified prior to hospital discharge [1]. Delayed pericardial effusion can arise within a week to 6 months post-cardiac surgery [4,5].…”

“…Loculated effusions are more common in this patient population because of pericardial adhesions or scarring associated with surgery [6,9]. Inflammation or bleeding may lead to fluid accumulation at the posterior and lateral part of the pericardium, making it difficult to visualize with Open Access *Correspondence: osman.adi@gmail.com 1 Resuscitation & Emergency Critical Care Unit, Department of Emergency and Trauma, Raja Permaisuri Bainun Hospital, Jalan Raja Ashman (Jalan Hospital), 30400 Ipoh, Perak, Malaysia Full list of author information is available at the end of the article transthoracic echocardiogram (TTE) [10,11]. Transthoracic echocardiogram has been identified as a sensitive modality to evaluate the heart for complications after cardiac surgery [12].…”